Healthcare Provider Details

I. General information

NPI: 1871624981
Provider Name (Legal Business Name): TAHYING VUE MHA1
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 GRAND AVE STE D
SACRAMENTO CA
95838-3466
US

IV. Provider business mailing address

811 GRAND AVE STE D
SACRAMENTO CA
95838-3466
US

V. Phone/Fax

Practice location:
  • Phone: 916-922-9868
  • Fax: 916-922-7342
Mailing address:
  • Phone: 916-922-9868
  • Fax: 916-922-7342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: